Individual provider Active NPI

Craig Lynn Raschke, D.C.

  • Chiropractor
  • College Station, TX
National Provider Identifier
1790103448
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12611 Issued in TX
Practice address
1605 Rock Prairie Rd
Suite 318
College Station, TX 77845-8358
Phone
(979) 696-1996
Fax
(877) 258-7732
NPI assigned
Mar 31, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12611 TX Primary

Addresses

Primary practice location

1605 Rock Prairie Rd
Suite 318
College Station, TX 77845-8358

Mailing address

PO Box 133
Wellborn, TX 77881-0133
Phone (979) 696-1996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12611TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Live Free Chiropractic and Rehabilitation LLC Chiropractor CurrentSince Aug 14, 2022 Accepting new patients
Gab Health Services P.a. Chiropractor CurrentSince Jul 2, 2019 Accepting new patients
College Station Chiropractic Chiropractor Past Accepting new patients

Locations

750 William D Fitch Pkwy
Ste 240
College Station, TX 77845
Phone (979) 669-1996

1121 Evergreen St
Longview, TX 75604
Phone (903) 759-5567

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1790103448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 133",
            "city": "WELLBORN",
            "state": "TX",
            "postal_code": "778810133",
            "telephone_number": "979-696-1996",
            "fax_number": "877-258-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 ROCK PRAIRIE RD",
            "address_2": "SUITE 318",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458358",
            "telephone_number": "979-696-1996",
            "fax_number": "877-258-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASCHKE",
        "first_name": "CRAIG",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.